Advanced/metastatic MPNST with LVEF <50% OR cumulative anthracycline ≥350 mg/m² OR ECOG ≥...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-MPNST-ADVANCED-DOXORUBICIN-UNSUITABLE`
Type	Red flag
Status	reviewed 2026-04-30
Diseases	`DIS-MPNST`
Sources	`SRC-ESMO-SARCOMA-2024` `SRC-NCCN-SARCOMA`

Red Flag Origin

Definition	Advanced/metastatic MPNST with LVEF <50% OR cumulative anthracycline ≥350 mg/m² OR ECOG ≥3 — anthracycline-based regimen unsafe.
Clinical direction	de-escalate
Category	organ-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "comparator": "<",
      "finding": "lvef_pct",
      "threshold": 50
    },
    {
      "comparator": ">=",
      "finding": "cumulative_anthracycline_mg_m2",
      "threshold": 350
    },
    {
      "comparator": ">=",
      "finding": "ecog_status",
      "threshold": 3
    }
  ],
  "type": "composite_clinical"
}

Notes

MPNST 1L is doxorubicin + ifosfamide (EORTC 62012). Cumulative anthracycline cap traditionally 450 mg/m²; 350 is conservative trigger. NF1-MPNST often young — congenital cardiac issues warrant baseline echo before regimen.

Used By

No reverse references found in the YAML corpus.